Changing Information of Nursing

1. Changing Information of Nursing

2. HOUSE KEEPING This is 1.5 Hour class Restrooms are located… Cell Phones Please turn off or change to vibrate If you must answer a call, please leave the room. 2

3. Learning Objectives • Identify the evolution of Nursing Informatics (NI) in health care • Identify the evolution of the Department of Veterans Administration (VA) Nursing informatics roles and articulate the role of existing strategic visions and missions of the Office of Nursing Service Informatics (ONSI) and the Chief Health Informatics Office (CHIO) • Describe the link between NI competencies and quality, safety, efficiency, and a healthy work environment • Describe the relationship of how NI can support informatics across the health care industry 3

4. Introduction 4

5. Introduction • Technology adoption improves safety, quality and access to care - supporting nursing informatics competencies development • Health and information technology exponential growth • Focus on quality, safety, & efficiency • Woven into the fabric of nursing practice, administration, education and research • Nursing leaders should define nursing informatics infrastructures at enterprise/system & facility/local level 5

6. What is Nursing Informatics? Presentations, publications and surveys on the functions of the nurse Informaticist: • http://www.himss.org/ASP/topics_FocusDynamic.asp?faid=243 • Nursing and Informatics for the 21st Century: An International Look at Practice, Trends and the Future - Book (2/8/2008) • Nursing Informatics 2007 Workforce Survey - Who Are We Now? - Survey Result (2/8/2008) • Nursing Informatics 2004 Workforce Survey - Who are we? - Survey Result (2/8/2008) • Nursing Informatics 101 - Presentation (2/8/2008) • An Emerging Giant: Nursing Informatics - Other Pubs (11/13/2007) 6

7. Nursing Informatics Definition • The integration of nursing science, computer and information science, and cognitive science to manage communication and expand the data, information, knowledge and wisdom of nursing practice (ANA, 2008) 7

8. Nursing Informatics Definition (cont.) “Nursing Informatics is a specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, and knowledge in nursing practice.  Nursing informatics facilitates the integration of data, information, knowledge, and wisdom to support patients, nurses and other providers in their decision-making in all roles and settings.  This support is accomplished through the use of information structures, information processes, and information technology.”  (ANA Scope and Standards of Nursing Informatics Practice, 2008, pg 1) 8

9. Nursing Informatics Definition (cont.) Nursing informatics is using technology, research, and professional experience to manage nursing data, information, and knowledge to improve practice and deliver better health care. Simpson, Roy (2006). In H. A. Park, P. Murray,& C. Delaney, C. (Eds.). Consumer-Centered Computer-Supported Care for Healthy People. Amsterdam, Netherlands: IOS Press, p 5 9

10. Domains of Nursing Informatics System Lifecycle Human Factors Information Technology Information Management Professional Practice Models and Theories 10

11. Nursing Informatics Competencies Informatics Nurse Specialist skills common to Nurse Executive skills • Computer literacy skills • Information literacy skills • Project management skills • Information management and communication • Leadership • Make judgments based on data trends and patterns • Change Management • Innovation 11

12. Nursing Informatics Functional Areas • Administration, leadership and management • Analysis • Compliance & integrity management • Consultation • Coordination, facilitation, and integration • Development • Educational & professional development • Policy development & advocacy • Research evaluation 12

13. Analyst Role Quality and Safety • Outcomes management • Synthesize knowledge • Performance improvement • Maintain data integrity and reliability • Aggregate data • Identify benchmarks • Develop performance measures • Assess workflow 13

14. Benefits of IT in Healthcare Safety • Computer technologies can place safety barriers within high risk processes to improve patient safety 14

15. Benefits of IT in Healthcare (cont.) Efficiency • Achieved through the use of computers and computer technology as a data management tool • Moving away from paper records – improves access to the data you need without flipping through a bulky patient record • Easier retrieval of data associated with a particular process • Data sharing is improved between disciplines 15

16. Benefits of IT in Healthcare (cont.) Quality Improvement • Allows for auditing to assure a consistent standard of care • Measurement of performance against standards of practice to identify systems issues and opportunities for improvement 16

17. Benefits of IT in Healthcare (cont.) Decision Support • Cues and information built into the system to assist the clinician in making care decisions 17

18. HIMSS 2007 Nursing Informatics Survey • Nursing Informatics Job Titles • 14% “clinical analysts” • 14% “informatics nurse specialist” or “nursing informatics specialist” • 9% “consultant” • 40% identified “other” • Director of Clinical Informatics, Clinical Informatics Coordinator, Clinical Systems Analyst, Clinical Informatics Specialist 18

19. What Can I Do For You? Data Management • Workload statistics • Performance monitoring • Performance improvement projects • Identification of problem areas • Before and after data • Regulatory compliance 19

20. What Can I Do For You? (cont.) Project Management • New applications • The job isn’t over when the software is implemented • Monitoring local usage • Reporting to oversight bodies • Training 20

21. What Can I Do For You? (cont.) Training and Education • New employees • Student nurses • Updates • Annual education/competency • Ongoing reminders 21

22. What Can I Do For You? (cont.) Be a National Voice • Software work groups • Alpha testing • Beta testing • National presentations • Oversight boards 22

23. Informatics Attitudes Appreciate the necessity for all health professionals to seek lifelong, continuous learning of information technology skills Value technologies that support clinical decision- making, error prevention, and care coordination Protect confidentiality of protected health information in electronic health records Value nurse’s involvement in the design, selection and implementation of information systems 23

24. Evolution of Nursing Informatics in VA Nursing Automated Data Processing Application Coordinator (ADPAC) Clinical Application Coordinator (CAC) Bar Code Medication Administration Coordinator (BCMA-C) VA Nursing Outcomes Database Coordinator (VANOD) & Nurse Information Specialist 24

25. Evolution of Nursing Informatics in Industry 25

26. Murielle Beene, Chief Nursing Informatics Officer Creating a Nursing Informatics Infrastructure Nursing Strategic Plan, Role of the Chief Nurse Informatics Officer Nursing Informatics Leadership 26

27. Creating Nursing Informatics Infrastructure • Defined roles, responsibilities and resources for Nursing Informatics • Enterprise/system level • Emerging role • Chief Nursing Informatics Officer (CNIO) • Facility/local level 27

28. Why a Nursing Informatics Department? Historical absence of administrative or informatics infrastructure Disparate data sources and reports No formal process for data validation No formal process to assess data accuracy Under resourced nursing management team Missing link to the operations – important data to inform decisions making 28

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30. Typical Leadership Relationships 30

31. Chief Nurse Executive Role • Critical in selection, implementation, and evaluation • Overall facility/healthcare system impact • Nurse Executive must be actively involved in over-all decision-making and implementation process 31

32. VHA Nursing Strategic Plan 2008-2012 Office of Nursing Service Vision includes… “Communicating nursing data using IT as an information management tool to manage easy access to forecast, access & communicate data.” • National Nursing goals: • Nursing Practice Transformation • Evidence-Based Practice • Excellence in Leadership • Workforce Management • Interconnected & Interdependent Critical Programs: • Informatics & Technology • Data Management • Research • Advanced Practice 32

33. Proposed Informatics Relationships 33

34. Emerging Chief Nurse Informatics Officer Role Set strategic vision for nursing informatics to support a collaborative practice that reaches across and between service lines Develop a vision, mission, and strategic plan for nursing informatics Leverage technology to create synergy in practice that will improve patient care delivery, efficiency, quality, and safety 34

35. Chief Nurse Informatics Officer Focus Area Strategic vision for informatics and impact on nursing practice and care delivery Human factors and ergonomics Technology assessment Data and databases Communication Resource planning and utilization Research, development and evaluation 35

36. Proposed Enterprise Infrastructure 36

37. Proposed Local Infrastructure 37

38. On Leadership… • “Innovation distinguishes between a leader and a follower.” • Steve Jobs • “A leader has the vision and conviction that a dream can be achieved. He inspires the power and energy to get it done” • Ralph Nader 38

39. NI Leadership Skills • Superb communication • Change management • Risk Assessment • Coalition building • Political finesse • Business acumen • Strategic application (ANA, 2008) 39

40. NI Leadership Role • Evidence-based practice • Computer literacy skills • Information literacy skills • Project management skills • Change management skills • Process management skills • Information management and communication • Data analysis • Trending & forecasting • Resource planning, utilization and evaluation • Technology assessment • Administration • Safety and quality • Make judgments based on data trends and patterns • Consultant • Innovator 40

41. Leadership Pearls DREAM, DARE, AIM to be an INNOVATOR Keep abreast of “latest greatest” technology trends Assess newest technology for “fit” and potential applicability in the clinical environment Leverage technology to improve quality, safety and nursing outcomes as you continue the ongoing journey toward innovation and clinical excellence 41

42. Questions? 42

43. THANK YOU!